SJ Sindu: Your poem, “The Talking Cure,” is dedicated to Bertha Pappenheim, one of Josef Breuer’s patients who was diagnosed with hysteria. Although she is better known by Breuer’s pseudonym for her, Anna O., Bertha Pappenheim was an accomplished feminist and activist in her own right. What drew you to her story? Why did you choose to write about her?

Sarah Fawn Montgomery: Bertha Pappenheim was a woman with tremendous accomplishments—writer, translator, social worker, feminist, activist, founder of the League of Jewish Women—yet she is remembered for her role in a male discovery and for the ways in which she deviated from traditional female roles. Much like Charlotte Perkins Gilman, who is often remembered as the madwoman who narrates the “Yellow Wallpaper,” despite her many accomplishments, Bertha Pappenheim’s diagnosis and treatment—brief in comparison to her rich professional life—are recorded in textbooks and thus what captures our cultural imagination.

I was drawn to her story because she is said to be the original psychoanalysis patient, cured because of the treatment’s success, but in fact she rejected psychoanalysis and most of her time spent in therapy. She was largely mischaracterized in early medical texts that heralded her physicians as heroes and brandished wild rumors about her psychosis and personality. Historians have since discovered many discrepancies between Bertha’s life and the way she is characterized in these texts, and it was most likely Bertha’s activism and her later resistance to the gender roles she found so confining as a young woman that allowed for her improvement. Writing about her was an act of discovery, of re-visioning and recasting her in history.

SJS: This poem points the finger at historians and researchers for taking part in the erasing of her own agency in her treatment. Why is this project important to you? To the poem?

SFM: Given the fact that many Victorian women were diagnosed with hysteria when the root cause of women’s unhappiness was most likely their limited social and political power, it is perhaps not surprising that Bertha became overshadowed by her illness, her symptoms and “strange” behavior, with physicians looking towards cure rather than cause, heralding their abilities rather than the patient’s individuality. In many aspects Bertha as woman became secondary to Bertha as patient, Bertha as case study. This happens frequently in medicine, doctors spending more time with a patient’s chart than with a patient, inquiring into symptoms and treatments rather than the many things that make a patient an individual. For patients, the details of their lives, the intricacies of their identities feel largely ignored.

This silencing of patient perspective by rewriting patient narratives into medically sanctioned language is what strikes me as important, because it is not exclusively an act of translation and healing—it is also an act of erasure. This is especially true when it comes to those with mental illnesses, those who experience reality and the world very differently than what has been deemed “sane” or “safe.” There is a long history of treatments for the mentally ill that seek to silence and erase—things like the Rest Cure that silenced women by way of inaction, emetics to induce vomiting, chains and cells to limit mobility, the lobotomies many assume we’ve moved past, but were replaced by chemicals like chlorpromazine (the first antipsychotic) that was actually heralded as “chemical lobotomy.” It’s important to examine this history, and seeking out these stories is an act of reclamation in many ways, a kind of activism that is crucial to help spread knowledge about neurodiversity.

SJS: Why the poem? Why not short story or essay? What does the poetic form allow for, aesthetically and in terms of craft, that other forms may not? And why the poem specifically for Bertha’s story?

SFM: There is power in true stories, in finding connection with other people who may be living life with depression or anxiety, with bipolar disorder or schizophrenia. There is also something incredibly jarring about learning the ways we’ve treated—and continue to treat—the mentally ill. True stores require we confront our social attitudes towards the mentally ill and our medical practices, which is precisely why I am so drawn to them for poems and nonfiction.

In terms of craft, poems allow for a creation of mythos through compression, juxtaposition, and lyricism. The poem asks readers to challenge traditional texts—history books, medical literature—and confront the mythology we have created abound psychoanalysis, psychopharmacology, and other treatments. The poetic form offers a new text, an optional narrative that places Bertha—patients, really—at the center, rather than her diagnosis, her treatment, her physicians.

SJS: This poem seems to be part of your larger project of writing about the psychiatric treatment of women by the medical and pharmaceutical industries. Your two recent poems, “After Electric” and “After Electric II,” which appeared in Blood and Thunder: Musings on the Art of Medicine, are about electrotherapy. Your memoir-in-progress, We’re All Mad Here: An American Pharma-memoir, is about your own experience with what you term neuromythology and the psychopharmacological industry. Can you tell us a little more about this project and why you think this subject is important to write about?

SFM: Examining the gendered nature of madness and questioning the rhetoric surrounding mental illness, patients, and treatment is what drives these projects. Understanding this largely gendered history is crucial—especially when considering the fact that contemporary pharmaceuticals for mental illnesses are prescribed at an alarming rate of 2:1 for women compared to men. I’m particularly interested in the language of psychopharmacology and the ways social construction impacts increasing rates of mental illness. I hope to reframe narratives of mental illness in order to represent a more nuanced understanding of the illness experience and medical industry, and provide medical information about madness and cure along with a thoughtful understanding of what it means to live with mental illness.

We’re All Mad Here draws from work in creative writing, women’s and gender studies, and illness and disability studies, and uses my personal experience with mental illness to interrogate  the rhetoric of mental illness treatments and challenge contemporary narratives surrounding mental illness. While chronicling my experience with diagnosis and treatments, I also examine America’s history of mental illness treatments—Quaker moral facilities to asylums, the Rest Cure to Prozac—arguing that the shift from physical and talk therapies to current chemical treatments has transformed madness from a temporary ailment to a chronic condition in our cultural imagination. I also investigate the historical construction of mental illness as a female malady to expose the ways current cultural attitudes towards women and their bodies coerces and controls madness. I study the memoirs, interviews, and medical records of other patients alongside my own experience, in order to question why our stories differ from the narratives we so often see portrayed in mass media, and why mental illness continues to increase in the United States despite so many “cures.”

As I navigated the mental health system the stigma and shame associated with my diagnosis and the lack of compassion and communication by those in the medical profession made me question nearly everything about myself—something many patients experience. My work seeks to provide a sense of community and legacy for those of us struggling with mental illness, as well as issuing a public warning about the danger of diagnosis and the complex and constructed definition of sanity.

SJS: What was your research process like in regards to your memoir, and smaller projects like this poem? What is something you learned in your research that blew your mind?

SFM: I am most interested in the ways we talk about mental illness and how this in turn impacts patients, the care they receive, and what we believe to be true about the illnesses themselves, so research is key. It’s not enough to tell my story—I need to connect it to the stories of others living with mental illnesses, to the history of care in this country, to current events and the ways mass media reports on those with mental illnesses. So the research involved reading lots of personal accounts like Kay Redfield Jamison’s An Unquiet Mind, Lauren Slater’s Prozac Diary, Andrew Solomon’s The Noonday Demon, William Styron’s Darkness Visible, and Elizabeth Wurtzel’s Prozac Nation, and examining their attitudes towards physicians and prescriptions, their discussions of mental illness as an inherent part of personhood or a separate entity, and moments where their narratives resisted the contemporary narratives about mental illness with which we are familiar.

I also read lots of books about the history of mental illness treatments like Barbara Ehrenreich’s and Deirdre English’s Complaints and Disorders, which examines the medical treatment of Victorian women, Herb Kutchins’ and Stuart Kirk’s Making Us Crazy, which traces the history of the ever-expanding DSM, and Ethan Watters’ Crazy Like Us, which explores how globalization is spreading mental illness. And Robert Whitaker’s Anatomy of an Epidemic and Mad in America provided all sorts of information that gave me pause, like the fact that chlorpromazine is actually neurotoxic by design, developed to numb the nervous system and derived from a chemical often used in agricultural insecticides. I was also staggered by the fact that lobotomies were practiced on young children to curb uncontrolled imaginations, or the large number of mentally ill patients sterilized without their permission. There’s so much we aren’t aware of concerning the history of various drugs, their side effects, and their prescribing patterns when we watch commercials on TV or see the portrayal of the mentally ill in mass media.

SJS: Is the memoir something you’re actively working on? What phase of the writing process is it in? When can we get excited about reading it?

SFM: The book is completed and under review with presses right now, so I hope it will be out in the world soon. There’s always the urge to revise, however, the more I learn from other scholars, activists, and neurodiverse folks. Plus, pop culture is ripe with current events—the upcoming election, recent films that portray disability in problematic ways, new medications hitting the market each day—that speak to the issues I raise in the book and continue the conversation.

Sarah Fawn Montgomery holds an MFA in creative nonfiction from California State University-Fresno and a PhD in creative writing from the University of Nebraska-Lincoln, where she teaches and works as Prairie Schooner’s Nonfiction Assistant Editor. She is the author of Leaving Tracks: A Prairie Guide and The Astronaut Checks His Watch (both from Finishing Line Press). Her work has been listed as notable several times in Best American Essays, and her poetry and prose have appeared in various magazines including Confrontation, Crab Orchard Review, DIAGRAM, Fugue, Georgetown Review, The Los Angeles Review, Natural Bridge, Nimrod, North Dakota Quarterly, The Pinch, Puerto del Sol, Southeast Review, Terrain, Zone 3 and others.

SJ Sindu’s debut novel, Marriage of a Thousand Lies, is forthcoming in 2017 from Soho Press. She has received scholarships from the Lambda Literary Retreat, the New York State Summer Writers Institute, and the Nebraska Summer Writers Conference. Her creative writing has appeared or is forthcoming in Brevity, The Normal School, The Los Angeles Review of Books, apt, Vinyl Poetry, PRISM International, VIDA, rkvry quarterly, and elsewhere.